Obesity and Health Consequences

While obesity is a disease in its own right, it poses a risk for the development of some other major health problems.

In addition to body mass index (BMI), a person’s waist circumference is important, because increasing abdominal fat is related to the risk for obesity-related diseases. Other risk factors for such diseases include hypertension (high blood pressure) and a sedentary lifestyle.

Diabetes
The body produces glucose from the foods we eat. The pancreas produces insulin, which transports the glucose from the bloodstream to the cells, where it is converted to energy. In diabetes, the level of glucose in the blood is too high.

Within the past 2 decades, the number of Americans with diabetes has risen from 7.8 million to about 25.8 million—more than 3 times as many people!

There are 2 types of diabetes: type 1 and type 2. In this article, we are concerned with type 2 diabetes. In this type, the body develops a resistance to insulin, causing the pancreas to make more insulin than normal. Over time, there is not enough insulin to move glucose into cells, and the blood glucose goes up. According to the CDC, 90% to 95% of people with diabetes have type 2 diabetes.

Diagnosis is by blood tests:

Fasting blood glucose (FBG), which checks the level of glucose in your blood after not eating for 8 hours,

Hemoglobin A1c (A1c), which estimates your average blood glucose level throughout the past 3 months, or

An oral glucose tolerance test, in which blood is drawn before you drink a sugary solution and then again, 2 hours later.

In addition, if you have signs or symptoms of too high glucose (excess urination, excess thirst, weight loss), any glucose, fasting or not, may be used to diagnose type 2 diabetes.

Diabetes can lead to damage to vital organs and may result in blindness, kidney failure, heart problems, and blood vessel and nerve damage (which may result in amputation). Diabetes shortens a person’s life expectancy, and an individual with diabetes has about twice the risk of dying than a person without diabetes.

PrediabetesPrediabetes is a condition that develops into full-blown type 2 diabetes in 10% of patients. Prediabetes is similar to diabetes, but the blood level of glucose (sugar), although higher than normal, is not as high as in true diabetes. You can have this condition without knowing it: it has no distinct signs or symptoms.

According to the Centers for Disease Control and Prevention (CDC), some 79 million adults in the US, aged 20 years or older, have prediabetes. As Americans age and become less physically active, the number of affected adults rises; the number of children and adolescents with the condition also is increasing.

Hyperlipidemia
Hyperlipidemia is a high level of lipids, or fats, in the blood. These fats, which include cholesterol and triglycerides, are needed for the body to function normally. However, if the levels get too high, a person is at risk for heart disease, blood-vessel disease, and stroke. People who have obesity are at risk for hyperlipidemia.

The foods we eat contribute to the fats in our blood. However, other factors, such as medications, hormones, and heredity, play a role as well. Hyperlipidemia can result if a person’s meals contain too much cholesterol, when the liver produces too much cholesterol, or from a combination of these factors.

Since fats are not water soluble, they need to be combined with proteins in order to enter the bloodstream. The combination of fats and proteins is called lipoprotein. Lipoproteins are low-density lipoprotein (LDL, also known as “bad cholesterol”), high-density lipoprotein (HDL, also known as “good cholesterol”), and very low-density lipoprotein (VLDL) cholesterol, which is composed mostly of triglycerides.

When too much LDL accumulates in the arteries, plaques form and can cause heart disease or stroke.

A high level of HDL, however, removes the buildup of LDL from the arteries.

Low levels of HDL and high levels of triglycerides can build-up in the arteries and also cause stroke or heart disease, especially in obese individuals or those with diabetes.

Metabolic Syndrome
Metabolic syndrome is a group of risk factors for cardiovascular (heart and blood vessel) diseases. It is present in about 34% of American adults. An individual is considered to have metabolic syndrome when 3 or more of the following factors are present:

Cancer
Obesity and overweight are associated with an increased risk for developing several types of cancer. According to the American Cancer Society, about one-third of cancer deaths are related to overweight/obesity, poor nutrition, and physical inactivity. Several malignancies have shown a clear link to obesity, including cancer of the colon and rectum, breast (in postmenopausal women), endometrium (lining of the uterus), esophagus, kidney, and pancreas.

Other forms of cancer that have a probable link to obesity include cancer of the liver and gallbladder, cervix, ovaries, and prostate, as well as blood cancers (such as non-Hodgkin lymphoma and multiple myeloma).

Other Conditions
Other health conditions have a high association with obesity.

Centers for Disease Control and Prevention. Diabetes: Successes and Opportunities for Population-Based Prevention and Control At A Glance 2011. August 1, 2011. www.cdc.gov/chronicdisease/resources/publications/AAG/ddt.htm. Accessed March 20, 2015.

Centers for Disease Control and Prevention. Overweight and Obesity: Adult Obesity Facts. Updated September 2014. www.cdc.gov/obesity/data/adult.html. Accessed March 20, 2015.

Centers for Disease Control and Prevention. Obesity in Children. Reviewed April 27, 2012. www.cdc.gov/obesity/childhood/basics.html. Accessed March 20, 2015.

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